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Abstract: This is a case of a 43-year-old female patient who presented with recurrent nasal itching, sneezing, runny nose, and nasal congestion for 3 years, with annual episodes lasting 1-2 at the turn of the season. She was diagnosed with allergic rhinitis, i.e., allergic rhinitis, after consulting our hospital due to poor treatment in the clinic. Therefore, after the diagnosis was clear, she was given medication according to the guidelines.
Basic information】Female, 43 years old
Disease Type】Allergic rhinitis
Hospital】Henan Provincial People’s Hospital
Date of consultation】September 2020
Treatment plan】Medication (budesonide nasal spray, loratadine tablets, eucalyptus pinocin enteric capsules, nasal abdomen and orifice granules)
Treatment period】2 weeks of outpatient treatment, 2 weeks of outpatient follow-up
Treatment effect] Complete relief of symptoms, no recurrence recently
I. Initial consultation
When the patient came to the consultation room, he had a heavy nasal sound, open-mouth breathing, accompanied by itchy eyes and conjunctival congestion. The patient complained of recurrent nasal itching, sneezing, runny nose, and nasal congestion for 3 years, with episodes lasting 1-2 months every year at the turn of the seasons. At that time, he went to the clinic and surrounding hospitals and was given nasal spray and oral loratadine tablets to relieve the symptoms, but the attacks often occurred at the turn of the season. Recently, the attacks started again, and after going to the clinic again and being given oral medication and nasal spray medication (the name of the medication is unknown), I felt that the treatment was not effective, so I came to the hospital and asked for treatment. According to the patient’s condition, he was considered to have seasonal allergic rhinitis and decided to give a combination of medications to control his symptoms.
II. Treatment history
After skin prick for allergens, the patient was found to be allergic to dust mites. Examination of the nasal cavity was consistent with the features of allergic rhinitis, with bilateral nasal mucosa edema and pallor, bilateral inferior turbinates hypertrophy, large amount of secretion in the nasal passages, and poor ventilation of the nasal cavity. The patient was given budesonide nasal spray; oral antihistamines, such as loratadine tablets; and a mucus promoter, eucalyptus pinene enteric capsules, to dilute the nasal mucus and promote mucus drainage; combined with Chinese medicines, such as nasal abnormalities and orifices granules, for 2 weeks. After 2 weeks of outpatient follow-up, 80% of the symptoms were relieved after taking the medication, and the symptoms were completely relieved after continuing the medication until 2 weeks.
III. Treatment effect
In the first week of medication, the patient’s symptoms were 80% relieved, the nasal itching and sneezing were obviously relieved, only a small amount of white nasal mucus was found in the nasal cavity, the symptoms of nasal congestion were relieved, no symptoms during daytime activities, and occasional nasal congestion at night when sleeping. In the 2nd week of medication, the drug dose was applied by half, and the symptoms were completely relieved after 2 weeks, and the symptoms of nasal itching, nasal congestion and runny nose disappeared. The patient was then instructed to use budesonide nasal spray every 2 angels, and the medication was discontinued after 1 week of continued consolidation. The patient was followed up in the outpatient clinic for 2 weeks and there was no sign of recurrence.
IV. Notes
We are glad that the patient’s rhinitis symptoms were controlled after treatment. Allergic rhinitis is a non-infectious inflammatory disease of the nasal mucosa in which nasal allergic symptoms occur in susceptible individuals after exposure to allergens, with the involvement of immunologically active cells and cytokines of the body. After treatment, patients need to pay attention to their living environment and surroundings, try to avoid contact with allergens, no flowers, no pets, no carpets at home, take medication on time and follow up regularly. When going out, if the outside environment is more polluted or during the pollen allergy season, it is recommended to wear masks and glasses to avoid contact with allergens and reduce the stimulation of allergens to the nasal mucosa and conjunctiva of the eyes. In addition, patients should take medication on time as prescribed by the doctor and follow up regularly. If medication is not effective, other methods of treatment can be considered.
V. Personal insight
Seasonal allergic rhinitis attacks during the alternation of seasons. The disease cannot be cured yet, but through prevention and avoidance of allergens and standardized drug treatment, patients’ various symptoms can be significantly controlled and the quality of life can be significantly improved. As in this case, the patient is allergic to dust mites and therefore avoids exposure in life. Patients can be regularly educated and followed up, medication should be standardized according to the guidelines during attacks and gradually reduced to control symptoms, regular follow-up, complete control of symptoms, and avoidance of allergens in ordinary life can avoid recurrent attacks.